Job Market

[JerseyRose]

Once you become an attending in pathology, can you still complain about the job market?

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[MetroPath]

Once you become an attending in pathology, can you still complain about the job market?

Yes, most of the attendings here complain about pathology all the time even though they have jobs and get paid well.

 

[Inez2000]

Yes, most of the attendings here complain about pathology all the time even though they have jobs and get paid well.

If there are more jobs, salaries might rise.

 

[Over9000]

I would wager that most of us who have jobs either live in good cities but are paid far too little, or live in remote hovels and are paid a fair income for cities, which means we are still paid too little.

We can still complain.

 

[yaah]

There is always something to complain about.

 

[Over9000]

There is always something to complain about.

That's true. There'd be no progress if there were no complaints.

 

[path24]

CAP showing 25 jobs while we are in our pathologist shortage! Actually a few aren't even for pathologists. The shortage is getting out of control...haha. It is actually getting worse....I believe this is the least jobs they have every advertised! It isn't going to get worse...it is. Down, down, down we go.

Nothing wrong with informing people about the crappy job market. I was a clueless med student that believed the lies. Pathology has been on the bottom of medicine for decades....and will only continue.

 

[postbacpremed87]

CAP showing 25 jobs while we are in our pathologist shortage! Actually a few aren't even for pathologists. The shortage is getting out of control...haha. It is actually getting worse....I believe this is the least jobs they have every advertised! It isn't going to get worse...it is. Down, down, down we go.

Nothing wrong with informing people about the crappy job market. I was a clueless med student that believed the lies. Pathology has been on the bottom of medicine for decades....and will only continue.

What about the baby boomers who will be retiring in 10-15 years? They have to retire at some point or die at their microscopes.

 

[MetroPath]

What about the baby boomers who will be retiring in 10-15 years? They have to retire at some point or die at their microscopes.

Most do die at their microscopes. The thing with Pathology is that you can work for a long time if you want to. Its not labor intensive.

 

[Thrombus]

What about the baby boomers who will be retiring in 10-15 years? They have to retire at some point or die at their microscopes.

Looks like we have some "fresh fish"!

When the "baby boomers" who are pathologists die/retire, so will the rest of the "baby boomer" non-pathologists who they are treating. Then there will still be the rest of us who are underemployed with even less baby boomers to treat, with decades surplus of graduating pathologists from the 5-th 6th whateverth year of fellowship.

We have been hearing about the "retirement cliff" myth for nearly an entire generational career!!!

 

[Mace1370]

Most do die at their microscopes. The thing with Pathology is that you can work for a long time if you want to. Its not labor intensive.

Most? Do we have any data on how many pathologists retire vs. how many work until death? As long as the ratio is even slightly tilted in favor of those in the retire category that should help the job market in the future.

 

[cmz]

There is a pathologist near where I work that is 80 years old and flies in from Houston (where he lives) on Monday morning and makes a return trip Friday afternoon. He obviously can't keep that up forever... or can he?

To echo what others have said, pathologists have a very long professional lifespan.

This is pretty much the only time you may ever see a pathologist retire:

(kidding, of course, I hope...)

 

[WEBB PINKERTON]

I like the older pathologists that sell out to ameripath (or whomever), pocket millions, and then continue to work into their 80s. Seen a lot of those over the years. I want to tell them to get the hell out of the way for the next generation.

I went to do a CAP inspection and ran into another one about 5 years ago. He stood up to try to shake my hand and then fell back into the chair. It was kind of a scary scene because he was so frail looking. He was in his early 80s and had sold out to labcorp about a decade earlier. That guy will work till he dies. Not sure if it's money or they just have no life but something keeps them working.

 

[postbacpremed87]

I like the older pathologists that sell out to ameripath (or whomever), pocket millions, and then continue to work into their 80s. Seen a lot of those over the years. I want to tell them to get the hell out of the way for the next generation.

I went to do a CAP inspection and ran into another one about 5 years ago. He stood up to try to shake my hand and then fell back into the chair. It was kind of a scary scene because he was so frail looking. He was in his early 80s and had sold out to labcorp about a decade earlier. That guy will work till he dies. Not sure if it's money or they just have no life but something keeps them working.

The job market is the only reason I am not pursuing pathology. I am a top 10% student and I think I would make a great addition to the field. I absolutely love it, the practice of it, and the lifestyle it affords. The job market situation is just too much though.

 

[WEBB PINKERTON]

The job market is the only reason I am not pursuing pathology. I am a top 10% student and I think I would make a great addition to the field. I absolutely love it, the practice of it, and the lifestyle it affords. The job market situation is just too much though.

Great decision. Don't waste your opportunity to be a physician on this field.

There is a major trade-off to have the lifestyle of a pathologist, the biggest being no job security and lack of respect from other physicians.

 

[Over9000]

The job market is the only reason I am not pursuing pathology. I am a top 10% student and I think I would make a great addition to the field. I absolutely love it, the practice of it, and the lifestyle it affords. The job market situation is just too much though.

It's a good move to avoid this field if you have other options. I used to urge students to do radiology instead of pathology since they have similar workflows but pathology was far worse in terms of income, prestige, job opportunities, private practice opportunities vs corporate drone jobs, and in having respected colleagues (lots of pathology residents are recruited from the bottom of the barrel, and most become attending staff eventually). Radiology's job market has taken a downturn and I am unaware of the possibility of it bouncing back, so I am reluctant to recommend it as heartily as in the past. Radiation oncology and anesthesia, other well-respected fields, seem to be in similar waters as radiology at present. Derm and surg subspecialties still have robust opportunities if you are interested in pursuing them.

 

[pongo]

The job market is the only reason I am not pursuing pathology. I am a top 10% student and I think I would make a great addition to the field. I absolutely love it, the practice of it, and the lifestyle it affords. The job market situation is just too much though.

Hopefully you are basing your assessment of the job market on more than this forum. When making the same decision, I also had my nerves frayed by some of the posters on here. I went into pathology anyway, and had plenty of opportunities to choose from, with a solid but not spectacular CV. So have the vast majority of the people I trained with. Of course we face many challenges, but so does every other specialty. I wouldn't trade my combination of lifestyle and income with any of my physician friends. And I love what I do.

 

[coroner]

Pathology has been on the bottom of medicine for decades....and will only continue.

There is a major trade-off to have the lifestyle of a pathologist, the biggest being no job security and lack of respect from other physicians.

I think we all acknowledge Pathology has never been a sexy specialty and is viewed by certain hospital administrators and practioners as being at the bottom rungs of the medical profession hierarchy. Where we have gotten our revenge is the low-stress lifestyle (which is backfiring because too many old timers are clinging to their microscopes with their cryptkeeper hands), ample time off, and relatively generous compensation. I use the word relatively because a few years ago, I saw a chart with average physician compensation by specialty based on hours worked per week and Pathology was #1. Another chart I saw supporting the low-stress lifestyle showed average retirement age by specialty and Pathology was #1 in highest average retirement age (again, not helping the younger generation).

My philosophy is do what makes you happy in life in general and find a way to incoporate that into your career. Whether that means pursuing a specialty with the highest compensation, ample time off, vast geographic flexibility and/or job security, the most intellectual stimulation/interest level, academic prestige, etc.

The optimists say if you find something you love then you will be successful no matter what. But, many of us don’t necessarily love what we do, nor do we have to. For a lot of physicians though, at the end of the day, it’s just a job that puts food on the table, sets up their kids’ college fund, allows a nice trip to Disneyworld or Europe once a year, and makes their monthly payments for the Porsche or ex-wife (or both). This is not the NFL where everybody feels lucky to be getting paid to do what we do. As this applies to the majority of people in our profession, then they should at least find something appealing (or tolerable) that they are willing to do for the next 30-40 years of their life based on whatever criteria makes them happy [see above paragraph]…

 

[gbwillner]

I think we all acknowledge Pathology has never been a sexy specialty and is viewed by certain hospital administrators and practioners as being at the bottom rungs of the medical profession hierarchy. Where we have gotten our revenge is the low-stress lifestyle (which is backfiring because too many old timers are clinging to their microscopes with their cryptkeeper hands), ample time off, and relatively generous compensation. I use the word relatively because a few years ago, I saw a chart with average physician compensation by specialty based on hours worked per week and Pathology was #1. Another chart I saw supporting the low-stress lifestyle showed average retirement age by specialty and Pathology was #1 in highest average retirement age (again, not helping the younger generation).

My philosophy is do what makes you happy in life in general and find a way to incoporate that into your career. Whether that means pursuing a specialty with the highest compensation, ample time off, vast geographic flexibility and/or job security, the most intellectual stimulation/interest level, academic prestige, etc.

The optimists say if you find something you love then you will be successful no matter what. But, many of us don’t necessarily love what we do, nor do we have to. For a lot of physicians though, at the end of the day, it’s just a job that puts food on the table, sets up their kids’ college fund, allows a nice trip to Disneyworld or Europe once a year, and makes their monthly payments for the Porsche or ex-wife (or both). This is not the NFL where everybody feels lucky to be getting paid to do what we do. As this applies to the majority of people in our profession, then they should at least find something appealing (or tolerable) that they are willing to do for the next 30-40 years of their life based on whatever criteria makes them happy [see above paragraph]…

LOL- I remember many years ago a WashU based website that broke down all physician reimbursement and QOL issues, and as you state Path was #1 when considering $/hour. I also used this as part of my decision making process.
Agree with everything the last 2 posters said, except that part about ample time off and vacation time (I seem to get neither, but that is mostly of my own doing).

the market may be "tight" and/or "terrible", but qualified people get jobs, and most get good jobs. At to date, after years of complaining, all evidence of the nature of the market remains mostly anecdotal. There are not lines of pathologists, as far as I am aware, at the unemployment office. It's not even clear to me how much an issue multiple fellowships are; most people I know who have done this did not do it because of a lack of job opportunities.

 

[yaah]

Everybody has an anecdote of an 80 year old pathologist, but outside of part time academics they aren't really that common. Don't mistake anecdotes for common practice.

And also don't mistake whatever they are calling the "retirement cliff" as an actual cliff. It's not like that. Everything is gradual. You can point to date X and say, "look, everyone just retired." You look at it over 5-10 year stretches. The major question is whether all the paths who are going to retire over the next 10 years are going to be replaced 1:1.

 

[LADoc00]

The facts, not B.S. anecdotes or propaganda from the CAP, just fact:
1.) There were 20,970 Active Pathologists in the US in 2005.
2.) In the same year, there were only 32,700 General Surgeons and 11,890 GI docs.

Now everyone in practice should be able to do the math in respects to how many General Surgeons and GI docs (far and away the top 2 referral sources for a vast majority of non-subspecialized pathologists) are needed to feed one pathologist employee making 250,000/year + benefits and payroll costs given the current ever declining reimbursement from CMS.
If you were to assume roughly 15% of pathologists are sub-spec only (CP blood bank, heme or derm being the top 3), then the ENTIRE U.S. should need only 5-6,000 Pathologists TOTAL.

Folks we are literally sitting at THREE TIMES that number.

ref: http://bhpr.hrsa.gov/healthworkforce/reports/physwfissues.pdf

 

[Sulfinator]

The facts, not B.S. anecdotes or propaganda from the CAP, just fact:
1.) There were 20,970 Active Pathologists in the US in 2005.
2.) In the same year, there were only 32,700 General Surgeons and 11,890 GI docs.

Those certainly are facts worth knowing.

 

[coroner]

Didn’t read thru all 111 pages, but noticed the chart with Supply of Physicians in Clinical Practice, Projected to 2020 which showed a -6% decline of General Surgeons and +4% increase in Pathology. Unless those fewer surgeons pick up the extra procedures needed with a reduction in their workforce and an aging population who will need more procedures, that doesn’t seem to bode well for our specialty…

 

[LADoc00]

A decline in General Surgeons equaling less procedures generating less 88305s, 88307s and 88309s comes on top of literally unprecedented back-to-back 6% cuts in Pathology reimbursement.

Meaning a 6% decline in GSurg board holders should be translating into double digit reductions in Pathology workforce training, not the obscene increases we are seeing.

Abundant cheap pathologists benefit large mega corporations that employ dozens if not hundreds of pathologists in mill type operations, Kaisers and government labs.

Follow the money.

I think even Yaah would have to agree that to be COMFORTABLE, not sitting around bored at work, you need around ~3-4 referring GI docs and at least as many general surgeons along with some substantial CP income per FTE pathologist to make a good living doing this.

The actual numbers indicate that at best 1 in 3 Pathologists could attain this standard. This is truly crazy.

 

[Sulfinator]

Didn’t read thru all 111 pages, but noticed the chart with Supply of Physicians in Clinical Practice, Projected to 2020 which showed a -6% decline of General Surgeons

Hold on, though. That 6% decline is between 2005 and 2020. We are already most of the way there, given that it is now 2015. If you look at the projected numbers for 2015 (21,690 general surgeons) vs. the projected numbers for 2020 (21,250 general surgeons), the projected decrease in general surgeons in clinical practice from now to 2020 is 440 general surgeons, which is only a decline of 2%. Furthermore, there is projected to be an increase between 2015 and 2020 in the number of general surgery subspecialists (180; 2.5%), a small increase in ORLs (20; 0.2%), an increase in OB/GYNs (1,840; 4%), and a small increase in gastroenterologists (60; 0.5%).

During the same time period (from 2015 to 2020) the number of pathologists in clinical practice is projected to go from 15,360 to 15,450 (an increase of 90 pathologists or 0.6%).

Don't get me wrong. I think we are training significantly more pathologist than our country needs, and I do advocate for reducing residency training slots. LADoc's conjecture about there being at least 3 times more pathologists out there than we need may not be that far off. Nevertheless, the projected changes between now and 2020 (in terms of pathologists and surgeons in clinical practice) are just not that drastic, in and of themselves; and I would hesitate to ascribe much meaning to them. Also, these data are from 2008. We could probably do with some more updated numbers.

 

[yaah]

I wonder how many of those 20,000 pathologists are researchers or academics that are highly specialized. Would be curious to know.

 

[Sulfinator]

I wonder how many of those 20,000 pathologists are researchers or academics that are highly specialized. Would be curious to know.

That 20,000-21,000 number for 2005 includes even those who were "engaged primarily in non-patient care activities and residents." When you subtract out the residents and those who aren't primarily involved in patient care activities, then the number you get is 14,850.

 

[coroner]

Anyone have a breakdown of how many Pathologists per state? I know Pennsylvania has about 1300 which would probably be ranked somewhere between top 5-10. Would there be more/better opportunities where there's a lower Pathologist : patient ratio or higher Surgeon : Pathologist ratio?

 

[gbwillner]

Also, why the focus on only general surgeons for estimating need? Why not combine all surgical subspecialties, with maybe the exception of Ortho? Where I come from, GS does mostly GI resections. You are also undersampling by excluding other services than need Path, like derm, even if it is a smaller percentage. Also need to accurately identify practicing AP pathologists #s.

But I agree with your reasoning. I would wager that true numbers are not so far off from the requirements. If they were not, the market today would be palpably worse. If there was really a 1:1 or 2:1 ratio of clinician to Path ratio, then people would be seeing like 3-5 specimens/day.

 

[coroner]

Because it's reasonable to say as LA already mentioned, the top two referral sources for the majority of Pathologists are general surgeons and GI. And, roughly only 15% of Pathologists don't rely on that: BB/TM, Derm, and Heme which includes AP and CP. According to the data (if it's an accurate predictor) GS will decline, although GI won't. Plus the surgeons are the one's giving us the 88307's and 309's. Although I would be glad to do a tray of 88305's from the GI doc anyday rather than gross a colon and hunt for lymph nodes to compensate...

 

[path24]

A decline in surgeons and our leaders are pushing for more pathologists. Yep trust our leaders....pushing for a worse future.

 

[LADoc00]

I wonder how many of those 20,000 pathologists are researchers or academics that are highly specialized. Would be curious to know.

I would actually doubt that is a higher rate than for say General Surgeons or GI docs as to be meaningless in the final ratios. This is also the reason Im quoting only board certified pathologists, because in my experience the pure basic science research type typically eschewed getting their certifications. That is, there is NOT some giant shadow pool of boarded AP/CP pathologist working for Genentech that somehow makes our numbers look more reasonable. I can assure of you that.

What we are looking at here is madness.

 

[2021Doctor]

Thank you to WebbPinkerton and LADoc for making sensible posts that cut through the haze and cover reality.

 

[WEBB PINKERTON]

Everyone's reality is different. I would advise anyone considering this field to talk to as many practicing pathologists as you can. It will be good practice for when you are job hunting/brown nosing.

 

[SpinachPizza]

I would NEVER make any important life decisions without first consulting Studentdoctor.net.

 

[turtle1966]

Yes, most of the attendings here complain about pathology all the time even though they have jobs and get paid well.

One can complain of own or neighbor's misfortune. Remember where there is smoke, there is fire.

 

[turtle1966]

The job market is the only reason I am not pursuing pathology. I am a top 10% student and I think I would make a great addition to the field. I absolutely love it, the practice of it, and the lifestyle it affords. The job market situation is just too much though.

You have made a good decision. Not having to worry for a job during residency, not having to look for fellowships, not being forced to move to foreign lands, not having to worry about keeping your job are "lifestyle" that many pathologists crave for.